1376542878 NPI number — REX HOSPITAL, INC.

Table of content: DR. J. TODD BRUNSON D.D.S. (NPI 1629268347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376542878 NPI number — REX HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REX HOSPITAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNC REX REHABILITATION AND NURSING CARE CENTER OF RALEIGH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376542878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4210 LAKE BOONE TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27607-6521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-784-6600
Provider Business Mailing Address Fax Number:
919-784-6623

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4210 LAKE BOONE TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-784-6600
Provider Business Practice Location Address Fax Number:
919-784-6623
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MATHEW
Authorized Official First Name:
BENJAMIN
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
919-784-1440

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  H0065 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 313M00000X , with the licence number: H0065 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: H0065 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 119744 . This is a "WELLPATH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7152480 . This is a "UNITED MEDICARE COMPLETE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0093U . This is a "STATE HEALTH PLAN OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3415369 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3416062 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: AN4793114001 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 33015 . This is a "PARTNERS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0093U . This is a "BLUE CROSS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7152480 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: XXXXXXXX9260 . This is a "AARP" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com